| NPI | 1811349293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA WOODHOUSE Office Manager 208-346-0688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-30245) |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2024-07-09 |